Acute haemolysis due to concentrated dialysis fluid.
Fatal acute haemolysis occurred in a 65-year-old man undergoing regular home haemodialysis for terminal renal failure. Circumstantial evidence indicating that the haemolysis resulted from exposure to concentrated dialysis solution was supported by in-vitro studies. Frank haemolysis in blood samples occurred at a dilution of greater than or equal to 1/2 of dialysis fluid. Osmotic fragility tests of surviving red blood cells showed 47% haemolysis at a dilution of 1/2 and greater than 90% haemolysis at a dilution of 1/1. Urgent design modifications to the proportionating machine are being undertaken to prevent such an accident recurring.
D000368:Aged; D000743:Anemia, Hemolytic / Q000209:etiology*; D006437:Hemodialysis, Home / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D009996:Osmotic Fragility; D011188:Potassium / Q000097:blood; D012964:Sodium / Q000097:blood
D012964:Sodium; D011188:Potassium